Ophthalmology Flashcards
After being struck by a baseball in the right maxilla, a 6-year-old girl with eyelid swelling has pain, nausea and vomiting when she tries to look up. The most likely diagnosis is
- Urgent MRI brain
- Orbital floor fracture repair if symptoms persist >1 week
- Emergent CT orbits followed by surgery to free an entrapped inferior rectus muscle
- Consult ophthalmology to rule out papilledema and consult neurosurgery
- MRI brain within 2 weeks
- Emergent CT orbits followed by surgery to free an entrapped inferior rectus muscle
A 2-year-old boy presents to the emergency department with the right eyelid inflammation. MRI demonstrates ethmoidal sinusitis with an obvious subperiosteal abcess of the medial orbital wall. The most important next step is
- Urgent drainage of the abcess
- Metronidazole IV
- Moxifloxacin PO and nasal decongestants
- Cefuroxime IV
- Nasal saline rinses
- Cefuroxime IV
A child with new onset eyelid ptosis, pupil dilation, exotropia and hypotropia most likely has
- CN III palsy
- CN VI palsy
- Cerebral aneurysm
- Horner syndrome
- Papilledema
- CN III palsy
A child with recurrent chalazia and photophobia has a small white dot on the right cornea for the past few weeks. The most appropriate management is
- Incision and drainage of the chalazia
- Patch to treat the corneal abrasion
- Warm compresses and eyelid care
- Tetracycline PO
- Urgent ophthalmology consultation
- Urgent ophthalmology consultation
An effective topical antibiotic for community bacterial conjunctivitis is…
- Fusidic acid bid
- Moxifloxacin tid
- Polymyxin B sulfate/gramicidin qid
- Gatifloxacin tid
- Any topical antibiotic is effective for this self-limited condition
- Any topical antibiotic is effective for this self-limited condition
Which statement is TRUE?
- Any eye suspected of globe rupture should be protected with a patch
- A large, slightly irregular pupil strongly suggests corneal laceration
- Simple eyelid lacerations should be sutured in the emergency department
- Diagnosis of microhyphema requires a slit lamp
- Uveitis is best characterized by diffuse conjunctival injection
- Diagnosis of microhyphema requires a slit lamp
In your brightly-illuminated exam room, a 3-month-old boy’s right pupil is slightly smaller than the left. Which of the following findings would suggest Horner syndrome of the right eye?
- A severe right upper eyelid ptosis.
- The right iris appears lighter in colour than the left.
- A mild right proptosis.
- Optic disc edema in the right eye.
- Limited abduction in the right eye.
- The right iris appears lighter in colour than the left.
A 2-year-old girl has a new onset swollen, erythematous left knee. You consider a diagnosis of juvenile idiopathic arthritis (JIA). Which of the following will be most helpful in confirming this diagnosis?
a) Bilateral episcleral injection near the limbus (“ciliary flush”)
b) Bilateral photophobia
c) Prominent blepharitis in both eyes
d) Mild enlargement of the globes
e) White blood cells in the anterior chamber of both eyes
e) White blood cells in the anterior chamber of both eyes
Which diagnosis could be suspected in a 5-month-old with exotropia and an abnormal red reflex?
a) Bilateral retinoblastoma
b) Monocular congenital cataract
c) Myopia resulting from congenital glaucoma
d) Infantile exotropia
e) All of the above
e) All of the above
A 2-month-old has “big, beautiful eyes”. It is hard to get her to open her eyes. You note tearing in the right eye. Red reflexes are present. What is the most likely diagnosis?
a) Neurofibromatosis type 1
b) Congenital glaucoma
c) Nasolacrimal duct obstruction
d) Persistent fetal vasculature
e) Stickler’s syndrome (COL2A1 mutation)
b) Congenital glaucoma
An obese 16-year-old girl with headaches and blurry vision presents with new onset diplopia. She takes isotretinoin for acne. You detect an esotropia on cover testing. The diagnosis is:
a) Right lateral rectus muscle dysfunction
b) Right cranial nerve VI palsy
c) Raised intracranial pressure
d) Isotretinoin-induced intracranial hypertension
e) All of the above
e) All of the above
What is the most likely visual field defect arising from a large pituitary macroadenoma?
a) Monocular visual loss
b) Bitemporal hemianopsia
c) Homonymous hemianopsia
d) Superior quadrantanopsia
e) Bilateral macular scotomata
b) Bitemporal hemianopsia
Which scenario best describes amblyopia?
a) Visual acuity improves to normal immediately when a myopic 6-year-old puts on her spectacles for the first time
b) A 3-year-old with a congenital cortical arteriovenous malformation has a complete right homonymous hemianopia
c) An 8-year-old with intermittent exotropia has an obvious strabismus for about 30 minutes before bedtime every night
d) Even after her congenital cataract is successfully removed early in life, a 2-year-old girl has poor visual acuity
e) A 5-year-old with optic nerve glioma has an afferent pupillary defect
d) Even after her congenital cataract is successfully removed early in life, a 2-year-old girl has poor visual acuity
A mother is concerned that her 6-month-old infant has an esotropia. What will be most helpful in confirming this diagnosis?
a) Corneal light reflex test.
b) Observation of the child’s wide nasal bridge and
prominent epicanthal folds.
c) Red reflex.
d) Direct ophthalmoscopy.
e) “Cover” or “cover-uncover” test.
e) “Cover” or “cover-uncover” test.
Which is true regarding the majority of cases of childhood-onset strabismus?
a) Strabismus results primarily from weak or “unbalanced” extraocular muscles
b) Strabismus results from congenital cranial nerve abnormalities
c) Despite normal muscles and nerves, the brain is unable to keep the eyes properly aligned either some or all of the time
d) Strabismus is associated with dyslexia
e) Poor eye tracking causes reading difficulties; this is best treated with “eye exercises” or “vision therapy”
c) Despite normal muscles and nerves, the brain is unable to keep the eyes properly aligned either some or all of the time
